Since the PSF contains all the relevant information from both aberrations and scatter, it has been a long history trying to directly record it in the living eye (Campbell & Gubisch,
1966; Flamant,
1955) using the ophthalmoscopic or double-pass approach. This technique (Santamaria, Artal et al.,
1987) is based on projecting a point source on the retina and recording the reflected image after double pass through the eye with a camera conjugated with the retina. As the PSF is imaged through the optics of the eye, the resulting double-pass image is the autocorrelation of the PSF (Artal, Marcos et al.,
1995). Based on this approach, measurement of light scattering in the eye can be performed by analyzing the intensity recorded at the peripheral part of the double-pass PSF in respect to the total intensity (Westheimer & Liang,
1994). This technique has proved useful for the quantification of scattering in situations with a significant presence, such as in cataract patients (Artal, Benito et al.,
2011) and in dry eye for the characterization of tear film quality (Benito, Perez et al.,
2011). The main limitation in this technique is not conceptual but practical. It arises from the extremely broad dynamic range of the PSF in the human eye that poses inherent difficulties in imaging both the central and peripheral areas of the PSF simultaneously. Practically, even with state-of-the-art detectors, scattered light intensities are above the noise level only for relatively small angles around the peak of the image. Beyond this angle, typically around 1 degree, the light in the PSF in the normal eye is so dim that it is not directly measurable. This limits the analysis of the scattered light from double-pass images to the central few tens of minutes of arc. An additional limitation arises from the fact that as the retinal image is analyzed, diffuse light from deeper layers (such as the choroid) may be interpreted as scattered light in the optics and therefore result to an overestimation of the optical PSF for these angles. This effect is less important when using shorter wavelengths (Lopez-Gil & Artal,
1997) since the diffuse light is strongly attenuated and confined due to the increased absorbance of hemoglobin (Delori & Pflibsen,
1989; Hodgkinson, Greer et al.,
1994). Similar limitations are found in light scattering measurements based on the analysis of the images acquired by Hartmann–Shack wavefront sensors (Nam, Thibos et al.,
2011; Thibos & Hong,
1999). Then, the measurement of the ocular light scattering based on the double-pass technique using a point source is particularly suitable for those cases in which the amount of scatter is relatively high, such as cataracts or dry eye patients, but is characterized by low signal-to-noise ratio and possible bias (due to retinal diffusion) in eyes with clear media. Alternative optical methods have been proposed based on the analysis of Purkinje images (Bueno, De Brouwere et al.,
2007) or the dynamic light scatter measurements (Ansari & Datiles,
1999; Datiles, Ansari et al.,
2008), but these methods analyze backscattered light rather than the visually relevant-forward scattered light.